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Dental anxiety


Expert reviewer, Dr Jennifer Pinder, Dental Anxiety Management Expert
Next review due August 2019

Dental anxiety is when you feel nervous, worried or uneasy about going to the dentist. You may have low or moderate levels of anxiety – where you feel anxious but can cope – or your levels of anxiety may be high or extreme. If you get extremely anxious about going to the dentist, you could have a dental phobia. This is when you have a persistent and intense fear of the dentist.

In the UK it’s thought that one in every three adults has moderate dental anxiety, and around one in every 10 adults has some form of extreme dental anxiety. Both adults and children can be affected. Getting help is important. If your dental anxiety isn’t managed properly, it could lead to more serious problems later on.

Lady at a dental appointment

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What causes dental anxiety?

Your dental anxiety may be caused by a bad experience you had when you were younger, or as a result of other people’s anxiety influencing your own thoughts and feelings. If you are unfamiliar with the dentist, this may also cause anxiety.

Your anxiety may be triggered and made worse by:

  • seeing or hearing the dentist’s drill
  • seeing or thinking about needles

You may also have dental anxiety because you have a fear of :

  • pain
  • blood
  • choking or gagging
  • not being in control or feeling vulnerable when lying in the dentist’s chair

Tips to help with dental anxiety

If you have dental anxiety, make sure you tell your dentist. If your dentist knows how you’re feeling, they can make a special effort to help you feel as comfortable and relaxed as possible. Your dentist will talk you through your appointment or procedure and answer any questions you may have. If you’re unsure about anything, don’t be afraid to ask your dentist to demonstrate things.

Bring your mobile phone or iPod with you, so you can listen to your own music during your appointment or procedure. It may help to distract you.

Your dentist can also recommend further treatment. Your dentist may be trained in these treatments, or may refer you to someone who is. See our section, ‘How can my dental anxiety be controlled?’ below for more information.

How can my dental anxiety be controlled?

Psychological techniques

Relaxation

Practising relaxation regularly can help lower your levels of stress and anxiety and help you to cope when you feel anxious. Some relaxation practices include deep breathing and muscle relaxation. One particular muscle relaxation technique is progressive muscle relaxation. Jane Bozier, Registered Nurse and Mindfulness Expert, here at Bupa has recorded her own guided progressive muscle relaxation for you to try. Relaxation can also be coupled with something called systemic desensitisation. This involves talking about your fears and ordering them from least to most troubling. You’re taught relaxation techniques and then gradually exposed to your fears to help you overcome them.

Guided imagery

Guided imagery is a technique that encourages you to channel your attention and focus it on a happy image. It helps you to relax and as a result, reduces your level of anxiety.

Talking therapies

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) helps you to gain control over negative thoughts and feelings associated with the dentist and helps change your behaviours that are associated with them. You can have CBT with a therapist, or self-guided CBT using resources such as books or apps. CBT can also be coupled with hypnotherapy.

Sedation

If you have a high level of dental anxiety and the above techniques aren’t working for you, your dentist may offer you sedation to relieve your anxiety and help you relax.

If you're sedated, you’ll be awake and able to respond to your dentist throughout the procedure. But you won’t be aware of what is happening, and may not be able to remember it. There are different ways you can be sedated:

  • Sedative tablets. Your doctor may prescribe you a small dose of an oral sedative to take before your procedure. This can reduce your anxiety – it’s known as oral pre-medication. When you arrive for your dental treatment, you may be given a higher dose oral sedative (this is known as oral sedation).
  • ‘Gas and air’ (inhalation sedation) also known as relative analgesia – during the procedure, you’ll breathe in a mixture of nitrous oxide and oxygen through a nasal mask.
  • A sedative injection – this will be done by your dentist, an anaesthetist or a doctor who is specially trained.

General anaesthesia

Nowadays, general anaesthesia isn’t used that much in dentistry, and you’ll only have it if it’s entirely necessary. Your dentist may refer you to the oral surgery department of your local hospital to consider you for a general anaesthetic during treatment, if you have severe anxiety or a dental phobia. General anaesthesia is carried out by a trained anaesthetist. You’ll be asleep and unable to respond during your procedure. You won’t remember it when you wake up.

Complementary therapies

Complementary therapies aren’t considered part of conventional medicine, but can be used alongside them to help treat certain conditions. Acupuncture is an example of a complementary therapy that may be used to help treat dental anxiety.

Dentists who specialise in treating anxious patients

Knowing where to find a dentist who specialises in treating anxious patient can be tricky. Bupa Dental Anxiety Management Expert, Dr Jennifer Pinder says: “Asking friends or family members to recommend a dentist is a good place to start. You can also search online for dentists who specialise in treating anxious patients. The British Dental Association (BDA) have a ‘find a dentist’ directory to help you find a dentist in your local area – it also outlines any special services they provide. If you want to confirm that a dentist has the appropriate qualifications to offer specific services, you can check their qualifications online at the General Dental Council (GDA) website. Another good place to get help is on the Dental Fear Central website. It’s a non-commercial site with lots of helpful resources, including a support forum for patients. ”


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Related information


    • Adult Dental Health Survey – England, Wales, Northern Ireland, 2009, Theme 8: Access Barriers to Care. The information centre for Health and Social Care, published March 2011. content.digital.nhs.uk
    • Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent. 2016; 8:35–50. doi: 10.2147/CCIDE.S63626
    • Children's Dental Health Survey 2013, Report 1: Attitudes, behaviours and children's Dental Health, England, Wales and Northern Ireland, 2013. Health and Social Care Information Centre, published March 2015. content.digital.nhs.uk
    • Hollins C. Levison's textbook for dental nurses. 11th ed. West Sussex: John Wiley & Sons, Ltd, 2013
    • Complementary, alternative, or integrative health: what's in a name? National Center for Complementary and Integrative Health. nccih.nih.gov, last updated June 2016
  • Reviewed by Laura Blanks, Specialist Health Editor, Bupa Health Content Team, August 2016
    Expert reviewer, Dr Jennifer Pinder, Dental Anxiety Management Expert
    Next review due August 2019



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